A History of the Present Illness

by Louise Aronson

  Suddenly, Bopha felt a tight, pinching pain in the upper parts of her arms, and the floor pulled away from her feet. Her father lifted her until their faces were nearly level. “Pay attention,” he yelled, his mouth leaking the familiar sour smell of old curry and ashtray bottoms and whiskey. Bopha held her breath until she got a funny feeling in her head that made her eyes want to close.

  Across the room, her mother repeated a single word like an incantation. At first, Bopha couldn’t make out what she was saying, and then she recognized that it was a name: Vanak. Her father must have heard it too. Without warning, he let go, and she fell to her knees. For a second, the apartment was perfectly quiet. Then her father grabbed his coat and left, slamming the door behind him. Immediately, the baby wailed, and soon enough, the others joined him. Bopha too felt something hot and hard in her throat, like a small animal trying to get out, but she swallowed again and again, until she made it go away.

  Later, she asked about Vanak. Her mother said he was a cousin who’d been arrested in Rhode Island after treating his son’s backache with cupping and coining. A teacher had seen the large round bruises and long red lines under the boy’s shirt and called the police. Vanak had spent nine months in prison, and when he came out, no one would give him a job. In America, her mother explained, a man could discipline his wife, but he must never leave marks on his children.

  The next morning, Bopha’s mother put Pheak in a sling on her back, handed Heang to Bopha, and took Neary’s hand. Bopha thought they were going to the market, but her mother turned right, not left, outside their building. At the Tenderloin Family Health Clinic, she told the Khmer assistant about Bopha’s rash, and an hour later they saw the doctor.

  With the assistant translating, Bopha’s mother explained the problem and did her best to answer the doctor’s questions, even though most of them had nothing to do with water dreams or rashes: Did Bopha like school? How was she spending her summer vacation? Was everything okay at home? Finally, he checked and poked Bopha all over, including her private places, and the nurse escorted her to the bathroom, where she peed into a clear plastic cup.

  When she returned to the exam room, Neary and Heang were playing in one corner and Pheak hung from their mother’s left breast, one tiny hand suspended in the air behind him. Her mother seemed to be studying something just over the baby’s head, but when Bopha walked farther into the room and looked at the same place, all she saw was a wall.

  “Well, look who’s back,” said the doctor. He smiled at Bopha, then wrote something on one of his papers before turning again to her mother.

  “So,” he explained, “I’m sending some tests, but I expect the results will be normal. Usually, the cause is stress. You need to talk to your daughter and get help for your husband if that’s where the trouble is. There are brochures in the waiting room and hotlines open twenty-four hours.”

  When he finished, the Khmer assistant turned to Bopha’s mother and said in Khmer, “An American problem.”

  The doctor looked at the assistant. “You told her everything I said?” he asked.

  “Oh, yes, of course,” said the assistant.

  The doctor sighed. He wrote a prescription for a cream to treat the rash and a referral to the clinic social worker. “They probably won’t bring her,” he said to the assistant, as if Bopha wasn’t there or as if she, like her mother, couldn’t understand English. “And even if they do, she only gets three visits. I doubt it’ll be enough.”

  That night, during a commercial break, her father’s face already dark and shiny but the red lightning rods not yet visible in the whites of his eyes, Bopha asked if she could go to the clinic for the appointments the doctor had recommended.

  Her father’s eyes narrowed. “How much?” he asked.

  “Free.”

  “What do they want?”

  “To fix me.”

  Her father poured himself another drink. He still had on his work clothes, a blue jumpsuit splattered with grease. His fingertips were stained too, and the bottle shook in his hand so some of the brown liquid jumped out of the glass and onto the table.

  He wiped at the spill, and little drops flew onto the carpet. “Your mother’s too busy to take you.”

  “It’s only three blocks,” Bopha said. “I can go by myself.”

  Her father waved her away.

  Bopha took a deep breath. If the water dreams were an American problem, then only an American could make them go away.

  She stepped between her father and the television. “The doctor wrote on a paper,” she said. “If I don’t go, we might get in trouble.”

  “Come here,” said her father.

  She took one step, then another.

  “Come,” he repeated.

  When she reached the couch, he pulled her toward him, then sniffed her head and tickled the smooth skin between her t-shirt bottom and skirt top.

  “Smart girl,” he said.

  The following Wednesday, Bopha walked to the clinic, crossing only on green lights, and gave her name at the big desk. She read Highlights for Children while she waited, studying the drawings of children playing in sunny backyards on lawns with daisies and dandelions, jungle gyms and swing sets.

  “Bo-fa?”

  The speaker was a woman with blond braids, long feather earrings, and a smile that took up the lower third of her face.

  “Boe-pah,” corrected Bopha. “Bo like bow and arrow, and pa like father.”

  The woman extended her right hand. “I’m Lenore,” she said, still smiling. “And I’m terrible with names, even American ones.”

  Bopha felt Lenore’s warm, bony hand encircle hers. Their arms went up and down, and when Bopha didn’t let go in time, Lenore laughed. But Bopha didn’t mind because she’d made an important discovery: handshakes meant grown up; they meant you counted. She could tell that the other patients, even the adults, were wondering who she was and why she was getting such special treatment. When their turns came, the nurse just stood beside the desk and called out a name. It was as if Bopha had come to the clinic not as a little girl who acted like a baby at night, but on important business. Whatever she did when she grew up, she decided, it would definitely require lots of handshaking.

  Lenore led the way down the hall and into a room crowded with stuffed animals, dolls, cars, blocks, and kid-size furniture. At first Bopha played while Lenore pretended not to be watching and making notes. Then Lenore asked questions that Bopha answered politely but not always honestly. Sometimes, she outright lied: no, she didn’t remember her dreams; no, her parents never discussed what happened in Cambodia. Other times, she told half-truths. She talked about how proud she was that her father had a job, but not about how on paycheck days he came home late and made her mother cry. And she mentioned their big television but not the time her oldest cousin had put on a program about the Vietnam War recommended by his teacher and all of a sudden her mother started screaming murderers and twisting the skin of her own arms and thighs, creating bruises that took weeks to fade.

  The session seemed much shorter than forty-five minutes. Bopha had only just begun tidying the dollhouse when Lenore stood and said, “Time’s up, but I’ll see you next week, same bat time, same bat place.”

  “Bat?” Bopha asked. “Like the animal?”

  “A joke,” Lenore said, a hand on Bopha’s back to guide her toward the door. “I’ll explain next week.”

  After the door closed behind her, Bopha stood blinking in the hallway. She felt certain she’d disappointed the social worker but had no idea why.

  At their second session, Lenore watched Bopha play for only a short while before suggesting that they sit down on the chairs at the small table with its neat rows of crayons and markers and butcher paper.

  “Why don’t you draw me a picture of your family,” Lenore suggested.

  Bopha thought that sounded like fun. She pulled crayons out of the box, choosing a different color for each person as she drew them: yellow for her mother, pin
k for Neary, bright green for Heang, and Pheak in baby blue. She wasn’t sure what color to make her father, but it didn’t really matter since the paper was so small, she’d run out of room.

  She arranged the crayons in a neat pile at the far end of the desk, the way her teacher had taught her, and waited.

  “Are you finished?” Lenore asked.

  “My dad’s too big. I can’t fit him.” She should have planned better. Maybe the social worker would make her start over.

  Lenore pushed the crayons back into the center of the desk. “I think you can. Why don’t you try?”

  Bopha studied her paper. Usually she was good at tests, but also usually tests had answers and all you had to do to get an A was study.

  The only white space left on her drawing started next to her mother’s head and moved across the top of the page. She thought of her father on the couch, where he lay down after work and on weekends, stretched out and snoring even with the TV on and Pheak crying and Bopha and Neary playing keep-away from Heang. Sideways he could sleep just like in real life. She chose the purple crayon and drew. When she finished, her father looked like a giant purple cloud. Bopha liked the picture better before, but now Lenore smiled, and that was more important.

  “Very good. Will you tell me who everyone is?”

  Bopha pointed at each person and named them.

  Lenore’s lips disappeared into her mouth, then came back out red and shiny. “Aren’t you missing someone?”

  Bopha stared at the social worker. She had never met anyone so smart. Picking up the milk-chocolate-colored crayon, she drew the baby in her mother’s stomach.

  Lenore’s head moved from side to side, then up and down. “Okay,” she said. “But what about you? Where are you?”

  Bopha laughed. “I’m not my family. I’m just me!”

  The social worker wrote something down on her pad. “Your parents,” she said. “Do you think they’re happy?”

  Bopha laughed again. She hadn’t expected the clinic visit to be just playing and joking.

  Lenore’s mouth moved into a smile shape, not her great big Hello, how are you? smile, but a smaller smile that didn’t show in her eyes. “What’s funny?”

  Bopha swung her legs under the table. Such a simple question had to be a trick, but she couldn’t think of any answer except the truth. “Happy’s for little kids,” she said. “My parents are all grown up.”

  Lenore leaned forward on her chair. “Anyone can be happy, even adults.”

  Bopha tried to think of happy grown-ups, but she could think only of fake ones on TV and in books. And maybe Lenore last week; this week she seemed upset.

  Down the hall, a baby screamed. On the wall above the table, the clown clock tick-tocked, and when the second hand got to six, it looked like a long hair hanging from the clown’s nose.

  Bopha giggled.

  “Do you know why you’re here?” Lenore asked her.

  She nodded.

  “Tell me?” Lenore said.

  Bopha rubbed her top teeth against her bottom lip. She wondered if the enormous stuffed giraffe in the corner of the room was the size of a real giraffe.

  “It’s because you wet your bed, isn’t it?” Lenore asked.

  Bopha thought a kid could climb on the giraffe. Her brother, Heang, would like that a lot, though she’d definitely have to give him a boost up.

  Lenore put a hand on her arm. “Maybe we could talk about the last time it happened, about what was going on at home that night before you went to sleep?”

  Bopha’s nose itched, but she didn’t scratch it. Maybe she could bring Heang the next time she came and he could ride the giraffe the way people rode horses on TV.

  Lenore said, “Or maybe you already have an idea why you wet your bed?”

  Bopha peeked at Lenore’s face, which now seemed like a giant question mark, then looked down at her lap. She pulled a loose thread off her skirt, careful not to make the material bunch up. Probably she should tell about the water dreams, but they were all different, and anyway, she liked water, especially when she was helping her mother by washing the rice for dinner or taking baths with Neary when they got to use the soap that made big bubbles. Bopha looked at the clock again, but it still wasn’t time to go home.

  Finally, Lenore asked if she wanted to color some more. Bopha nodded, and the social worker passed her a clean sheet of paper.

  The next week, after they shook hands and Lenore led the way down the hall to the therapy room, Bopha opened the door for herself and headed toward the play area.

  “No,” Lenore said. “Over here.”

  On the little table, a large shopping bag had replaced the paper and crayons.

  “It’s a present,” Lenore said, her voice rising, as if she weren’t sure herself.

  The bag was big and white and shiny, with writing on the side. Bopha eyed the long plastic handles. Her mother could use a bag like that for marketing.

  “Open it?” Lenore said.

  One at a time, Bopha pulled items from the bag and placed them in a neat pile on the table: a bedsheet cut in half, two towels, and two rubber pads.

  “So your mattress doesn’t get wet,” Lenore said. “I’ll show you?”

  In the middle of the table, Lenore placed a rubber pad, then one of the towels, and, over it all, one of the half bedsheets. Finally, she demonstrated how the lump of cloth could be flattened by tucking the ends of the sheet into the sides of the bed.

  “When you wake up wet,” Lenore explained, “you can pull all this off, throw it onto the floor, and go back to sleep on the dry regular sheet. Okay?”

  Bopha wanted to ask Lenore if one end could be kept loose so she and Neary could sleep together again, but she didn’t bother. The towels would never end up on her bed. They were too beautiful, fluffy and yellow and soft, much nicer than the thin, scratchy ones hanging in the bathroom at home. The towels would be for her parents.

  She felt the wetness on her cheeks before she realized she was crying.

  “What is it?” Lenore asked, but Bopha couldn’t speak. The social worker led her to the sofa against the wall, sat down beside her, and held out a box of tissues.

  Bopha’s body shook and her nose ran. She turned her face into the cushions, but the harder she tried to stop, the worse it got.

  Lenore rubbed her back. “Good,” she whispered over and over. “Good girl.” And then, as Bopha quieted, Lenore began talking fast, her voice low and serious and without question marks. She said that sometimes people felt things that scared them, and when those things couldn’t come out the right way, they leaked out in other ways. She said that although Bopha might always have to be her mother’s helper and take care of her younger siblings, she didn’t have to get straight As or grow up more quickly than other children. She said that if there was trouble between her parents, it wasn’t Bopha’s fault and it wasn’t her job to make it better.

  Finally, Bopha quieted. She didn’t blame Lenore for not being able to fix her. Maybe the doctor was right and three sessions just weren’t enough. Or maybe hers was an especially bad case. Then again, Lenore had helped; Bopha might not get to use the new towels, but she could use the sheets and the pads and maybe even her parents’ old towels. If she had all that, she could clean up after herself, and it would be almost as if she didn’t have a problem at all. She crossed the room to the table and put the items back into the shopping bag. Then she walked to the door.

  Lenore met her there and put a hand on her shoulder. “You know this is our last session?”

  Bopha nodded.

  “Are you sure there isn’t anything you want to tell me before you go?”

  Bopha hugged the bag to her chest so no one could steal it on her way home. She smiled at Lenore. “Only thank you very much,” she said, and then she walked down the hall and through the clinic’s crowded waiting room with her chin on the bag and her eyes on the floor.

  Giving Good Death

  In many ways, Robert’s arrest was
liberating. In the county jail, he ate lunch sitting down, exercised regularly, and, with the benefits of 24/7 lighting and permanent lockdown because of what the pedophile one cage over called their VEP or very endangered person status, began tackling some of the great books, large and small, he had always meant to read but never quite seemed to have time for: Middlemarch and The Magic Mountain, William Carlos Williams’s The Doctor Stories and The Collected Works of Anton Chekhov. After his arrest, Robert had at most one appointment a day, and he was the patient.

  Twice a week at ten fifteen, a guard escorted him through the multiple locked doors of a facility that had been hailed in the San Francisco Chronicle as “a stunning victory for architectural freedom over bureaucratic stupidity” by a Pulitzer Prize–winning architecture critic who’d obviously never experienced the place from inside its frosted windows. Unlike the architect, Robert’s experience of the building had nothing to do with freedom. The guard marched him down the corridors shackled at wrists and ankles, then shoved him into the windowless lime-green room where he was expected to spend a county-designated psychiatric hour—forty minutes—discussing his past. The room had two hardwood chairs that made Robert nostalgic for the comforts of his steel bunk, and a metal table screwed into the floor. The psychiatrist, who introduced herself simply as Dr. Sung, often worked for the DA, though in Robert’s case she served as a mutually agreed upon consultant. She was businesslike, younger than he—he guessed late thirties—and wore the weary, harassed expression of a woman with too much to do. From a smudge on the hem of her skirt, he suspected young children, though he never found out for sure. She gave nothing away, which was okay by him. With little to do, he appreciated the challenge.